AN EXPERIMENTAL STUDY TO EVALUATE THE EFFECTIVENESS OF APPLICATION OF ALMOND
OIL MASSAGE ON BREAST FEEDING AMONG POSTNATAL
1*
Vanitha, N.,
1
Obstetrical and Gynaecological Nursing, Kasturba Gandhi Nursing College, Sri Balaji Vidyapeeth,
2
Dept. Of Obstetrics and Gynaecological Nursing, Kasturba Gandhi Nursing College, Sri Balaji Vidyapeeth,
3
Principal, Kasturba Gandhi Nursing College, Sri Balaji Vidyapeeth Pillaiyarkuppam, Puducherry
ARTICLE INFO ABSTRACT
The breast milk is very healthy and full of nutrition, it provides the primary source of nutrition for newborns before they are able to digest more diverse food. The breast milk also contains balanced nutrients that are
viruses, bacteria, and parasites, since an infant’s immune system is not fully developed until the age of 2 yrs. Due to some reasons, few lactating mothers unable to give b
there is an inadequate milk secretions. Consuming almond oil during lactation promotes milk secretions, as helps in synthesis of Vitamin
oil contains fatty acids, pr
increased secretion of breast milk.
application of almond oil massage on breast feeding among postnatal mothers undergone MGMCRI Puducherry.
and 60 mothers Undergone LSCS were selected using simple random sampling technique method was adopted for this study.
effective in promoting breast feeding among post natal mothers underwent LSCS by using UNICEF based breast feeding assessment tool and which can be effectively utilized as a non
management for promotion of br
p<0.001* level. Thus the application of almond oil massage can be used as a complimentary therapy in promoting breast milk secretion.
Copyright © 2018, Vanitha et al. This is an open access distribution, and reproduction in any medium, provided
INTRODUCTION
The breast milk is very healthy and full of nutrition; it provides the primary source of nutrition for newborns before they are able to digest more diverse food. The breast milk also contains balanced nutrients that are required for brain development, growth and a healthy immune system that act against viruses, bacteria and parasites since an infant’s immune system is not fully developed until age of 2 years, human milk provides a distinct advantages over formula. Breast Feeding should commence as soon as possible after giving birth and every 1 to 3 hours per 24 hours (8-12 times/24 hours) Babies should be breast fed exclusively for the 6 months.
*Corresponding author: Vanitha, N.,
Obstetrical and Gynaecological Nursing, Kasturba Gandhi Nursing College, Sri Balaji Vidyapeeth, Pillaiyarkuppam, Puducherry
ISSN: 0975-833X
Vol.
Article History: Received 20th July, 2018
Received in revised form 05th August, 2018
Accepted 18th September, 2018
Published online 31st October, 2018
Citation:Vanitha, N., Prof. Annie Annal, M. and Dr. Renuka
almond oil massage on breast feeding among postnatal mothers undergone lscs at mgmcri Puducherry
Research, 10, (10), 74435-74439.
Key Words:
Effectiveness, Almond oil, Post Natal Mothers, Breast Milk.
RESEARCH ARTICLE
AN EXPERIMENTAL STUDY TO EVALUATE THE EFFECTIVENESS OF APPLICATION OF ALMOND
OIL MASSAGE ON BREAST FEEDING AMONG POSTNATAL MOTHERS UNDERGONE LSCS AT
MGMCRI PUDUCHERRY
Vanitha, N.,
2Prof. Annie Annal, M. and
3Dr. Renuka K.
Obstetrical and Gynaecological Nursing, Kasturba Gandhi Nursing College, Sri Balaji Vidyapeeth,
Pillaiyarkuppam, Puducherry
Gynaecological Nursing, Kasturba Gandhi Nursing College, Sri Balaji Vidyapeeth,
Pillaiyarkuppam, Puducherry
Principal, Kasturba Gandhi Nursing College, Sri Balaji Vidyapeeth Pillaiyarkuppam, Puducherry
ABSTRACT
The breast milk is very healthy and full of nutrition, it provides the primary source of nutrition for newborns before they are able to digest more diverse food. The breast milk also contains balanced nutrients that are require for brain development, growth and a healthy immune system that act against viruses, bacteria, and parasites, since an infant’s immune system is not fully developed until the age of 2 yrs. Due to some reasons, few lactating mothers unable to give b
there is an inadequate milk secretions. Consuming almond oil during lactation promotes milk secretions, as helps in synthesis of Vitamin-B, and also helps in emulsification of globules. As almond oil contains fatty acids, proteins, calcium, and linolenic acids and it is having emollients and helps in increased secretion of breast milk. Aim: This study was aimed to assess the effectiveness of application of almond oil massage on breast feeding among postnatal mothers undergone
MGMCRI Puducherry. Methodology: Experimental Research Design group pre
and 60 mothers Undergone LSCS were selected using simple random sampling technique method was adopted for this study. Results: The study results s
effective in promoting breast feeding among post natal mothers underwent LSCS by using UNICEF based breast feeding assessment tool and which can be effectively utilized as a non
management for promotion of breast milk secretion . The obtained test value was significant at p<0.001* level. Thus the application of almond oil massage can be used as a complimentary therapy in promoting breast milk secretion.
access article distributed under the Creative Commons Attribution License, the original work is properly cited.
The breast milk is very healthy and full of nutrition; it provides the primary source of nutrition for newborns before they are able to digest more diverse food. The breast milk also contains balanced nutrients that are required for brain development, growth and a healthy immune system that act against viruses, bacteria and parasites since an infant’s immune system is not fully developed until age of 2 years, human milk provides a Breast Feeding should commence as soon as possible after giving birth and every 1 to 12 times/24 hours) Babies should be
Obstetrical and Gynaecological Nursing, Kasturba Gandhi Nursing College, Sri Balaji Vidyapeeth, Pillaiyarkuppam, Puducherry.
Breast milk has important ingredients that are not found in any infant formula, to build baby’s immune system. Breast milk changes from feed to suit each baby’s unique needs, making the perfect food to promote healthy growth and development. Breast milk is more easily digested than any infant formula. Breast milk fed babies are rarely constipated and are less likely to get diarrhoea. Breast milk has no waste products and leaves no carbon foot print. Breast milk fed babies have low risk of gastrointestinal illness, allergies, asthma, Diabetes, obesity, some childhood cancer, Respiratory tract infection, Urinary Tract infection, SIDS (cot death)
nature of breast milk is enhanced by the fact that it is asset given by nature and has no price. The vital components for the infants in tropical countries are breast feeding and avoidance of infections as we know so many advantages of breast feeding it is easily digestible, protecting against infections.
International Journal of Current Research Vol. 10, Issue, 10, pp.74435-74439, October, 2018
DOI: https://doi.org/10.24941/ijcr.32684.10.2018
Vanitha, N., Prof. Annie Annal, M. and Dr. Renuka K. 2018. “An experimental study to evaluate the effectiveness of application of almond oil massage on breast feeding among postnatal mothers undergone lscs at mgmcri Puducherry
AN EXPERIMENTAL STUDY TO EVALUATE THE EFFECTIVENESS OF APPLICATION OF ALMOND
MOTHERS UNDERGONE LSCS AT
Dr. Renuka K.
Obstetrical and Gynaecological Nursing, Kasturba Gandhi Nursing College, Sri Balaji Vidyapeeth,
Gynaecological Nursing, Kasturba Gandhi Nursing College, Sri Balaji Vidyapeeth,
Principal, Kasturba Gandhi Nursing College, Sri Balaji Vidyapeeth Pillaiyarkuppam, Puducherry
The breast milk is very healthy and full of nutrition, it provides the primary source of nutrition for newborns before they are able to digest more diverse food. The breast milk also contains balanced require for brain development, growth and a healthy immune system that act against viruses, bacteria, and parasites, since an infant’s immune system is not fully developed until the age of 2 yrs. Due to some reasons, few lactating mothers unable to give breast milk to their infant when there is an inadequate milk secretions. Consuming almond oil during lactation promotes milk B, and also helps in emulsification of globules. As almond oteins, calcium, and linolenic acids and it is having emollients and helps in This study was aimed to assess the effectiveness of application of almond oil massage on breast feeding among postnatal mothers undergone LSCS at xperimental Research Design group pre-test post-test design and 60 mothers Undergone LSCS were selected using simple random sampling technique-lottery show that almond oil massage was effective in promoting breast feeding among post natal mothers underwent LSCS by using UNICEF based breast feeding assessment tool and which can be effectively utilized as a non-pharmacological east milk secretion . The obtained test value was significant at p<0.001* level. Thus the application of almond oil massage can be used as a complimentary therapy
License, which permits unrestricted use,
Breast milk has important ingredients that are not found in any infant formula, to build baby’s immune system. Breast milk changes from feed to suit each baby’s unique needs, making the perfect food to promote healthy growth and development. Breast milk is more easily digested than any infant formula. Breast milk fed babies are rarely constipated and are less likely rrhoea. Breast milk has no waste products and leaves Breast milk fed babies have low risk of gastrointestinal illness, allergies, asthma, Diabetes, obesity, some childhood cancer, Respiratory tract infection, Urinary SIDS (cot death). The uniqueness and precious nature of breast milk is enhanced by the fact that it is asset given by nature and has no price. The vital components for the infants in tropical countries are breast feeding and avoidance now so many advantages of breast feeding it is easily digestible, protecting against infections.
OF CURRENT RESEARCH
It is readily available; it contains lactoferin which hinders growth of E. coli. Studies show that 80% of infants growing healthy are those who receive breast feeds (Semin Pennato, 2009). Many new mothers do not always experience the instantly in – mother – love emotions. Bonding is gradually unfolding experience that can take hours, days, week or even months to develop. Bonding makes parents to shower their baby with love and affection and to protect and nourish the little one. A study has discovered that the action of a baby sucking actually changes how the mother’s brain behaves. This results in a massive rush of the ‘love hormone’ oxytocin in women’s brain. The release of the chemical in massive surges enhance a mothers feeling of trust, love and affection (Berkeley, 2011). The benefits of breast feeding for the health and wellbeing of the mother and baby are well documented, WHO recommends early initiation of breast feeding. A recent trial has shown that early initiation of breast feeding could reduce neonatal mortality by 22%. In developing countries alone early initiation of breast feeding could save as many as 1.45 million lives each year by reducing deaths mainly due to diarrhoeal disorders and lower respiratory tract infection in children (Betty, 1998). In South Asia 24-26% of babies born in Bangladesh, India and Pakistan are breast feeding within first hour of birth, whereas the corresponding rate of Sri Lanka 75% (Cunningham, Leveno, Bloom and Spong, 2010).
UNICEF reports that one in two babies worldwide are not breastfed within the recommended first two hours of birth, and not getting the nutrients they need, which increases their chances of death by a whopping 80%. This news—and the realization that something needs to change on a global level. “Making babies wait too long for the first critical contact with their mother outside the womb decreases the newborn’s chances of survival, limits milk supply and reduces the chances of exclusive breastfeeding,” France Bégin, UNICEF Senior Nutrition Adviser, said in a news release. “If all babies are fed nothing but breast milk from the moment they are born until they are six months old, over 800,000 lives would be saved every year”. “Breast milk is a baby’s first vaccine, the first and best protection they have against illness and disease,” Bégin says. “With newborns accounting for nearly half of all deaths of children under 5, early breastfeeding can make the difference between life and death.”
So many studies gave information about the use of herbs and essentials mainly almond oil in many diseases. Also almond oil helps to promote milk secretions. Almond oil contains rich concentration of Oleic and liolenic essential fatty acids.
Almond oil rich in Galectogogues interact with
the dopamine system in such a way to increase the production
of prolactin; specifically, by blocking the Dopamine
2receptor. There is some evidence to suggest that mothers who are unable to meet their infants' breastfeeding needs may benefit from galactogogues. Galactagogues may be considered when non-pharmacologic interventions are found to be insufficient. Most of the studies were done on almond oil on promotion of breast milk secretions studies found that massaging with almond oil helps in promotion of breast milk secretions. Studies found that massaging with almond oil two times a day gives good results on promotion of breast milk (Bergmann, 2010).
statement of the problem: “An experimental study to
evaluate the effectiveness of application of almond oil massage
on breast feeding among postnatal mothers undergone LSCS at MGMCRI Puducherry”
Objectives
• To assess the breast milk secretion during pre-test among postnatal mothers.
• To evaluate the effectiveness of almond oil massage on breast feeding during post-test among postnatal mothers.
• To find out the association between the breast milk secretion and the selected demographic variables of postnatal mothers.
Research hypotheses
H1: There will be an increase in the secretion of breast milk after application of almond oil in postnatal mothers.
MATERIALS AND METHODS
Methodology: Experimental Research Design group pre-test
post-test design and 60 mothers Undergone LSCS were selected using simple random sampling technique-lottery method was adopted for this study.
Criteria for sample selection
Inclusion Criteria: Post-natal mothers underwent LSCS and
admitted in postnatal ward giving breast feeding to their babies and willing to participate.
Exclusion Criteria: Post-natal mothers whose babies is in
NICU and Mothers, who are allergic to almond oil.
Development and description of tool
The tool was developed based on review of literature, opinion from experts in the field of medical and nursing. The following steps were undertaken to prepare the final tool
The tool consists of two sections:
Part A: consists of demographic variables which include Age,
Family income, Religion, Diet pattern, Educational status, Occupation, Gravida, and Para.
Part B: Unicef based breast feeding assessment tool
Validity and reliability: Validity is the most important simple
methodological criteria for evaluating any measuring instrument. Validity reflects how accurately the measures yield information about the true or real variable being studied. Reliability as “the consistency with which an instrument measures the attribute”. An instrument is said to be reliable if its measures accurately reflect the true score of the attribute under investigation. Reliability coefficients higher than 0.70 are often considered satisfactory, but coefficients greater than 0.80 are far preferable. Polit et al. (2007)
Reliability of the tool: The researcher used to test retest
Part –B. Unicef based breast feeding assessment tool
Characteristics Score 1 Score 2 Score 3 Score 4 Score 5
1 Urine Output (Wet Napies) 1st
Day
No Napkin Change 1 Napkin 2 Napkin 3 Napkin More Than 4 Napkin
Urine Output (Wet Napies) 5th
Day
1 - 2 Napkin Change 3 Napkin 4 Napkin 5 Napkin More Than 5 Napkin
2 Appearance And Frequency of
Stools (1st Day)
Nil 5 Rupees Coin Size 1 Rupees Coin
Size
2 Rupees Coin Size
10 Rupees Coin Size
Appearance And Frequency of
Stools (5th Day) Nil 1 Time 2 Time 3 Time More Than 3 Times
3 Weight Loss More Than 12 % More Than 11% More Than 10% More Than 9% Less Than 8 %
4 Number Of Feeds Less Than 3 Times 3 – 4 Times 5 – 6 Times 7 – 8 Times 9 – 10 Times
5 Sucking Pattern During Feed No Sucking Noisy Feeding Slow Sucking Intermittent
Sucking
Rapid Sucking
6 Length Of Feed Less Than 5 Minutes 5 Minutes 10 Minutes 20 Minutes 30 Minutes
7 End Of The Feed Baby Does Not
Release Spontaneously Intermittent Release Immediate Release
Late Release Baby Leaves Breast
Spontaneously
8 Offer Of 2nd Breast Not Fed In 2nd Breast Poor Sucking Slow Sucking Intermittent
Sucking
According To Appetite Takes Good Sucking
9 Baby’s Behaviour During And
After Feed
Vigorous Cry Irritable Cry Intermittent Cry Weak Cry Baby Calm And
Relaxed
10 Shape Of Nipple After Feeds Altered Flat Inverted Slightly
Elongated
Same Shape, No Change
11 Mother’s Report On Her
Breasts And Nipples
Damaged / Sore Nipple
Engorgement Mild Pain Slight
Discomfort
Comfortable
12 Sleep Sleep with irritable
cry
Intermittent sleep After feed sleeps
up to 1hour
After feed sleeps up to 2 hours
After feed sleeps up to 3 hours
13 Perceived Breast feeling of
mother in feeding
Could not find any change
Unsatisfied breast fullness
Feeling breast fullness on either side
Feeling breast fullness
Feeling Breast fullness before feeding and empty after feeding Score:
13-26: Poor 27-39: Fair 40-52: Good 53-65: Very Good.
Study Results
Distribution of demographic variables of postnatal mothers underwent lscs
S.No Demographic Variables Experimental Group (30) Control Group (30)
n % n %
1. Age (in years )
• 18-25 years
• 25-35 years
• 35-45 years
17 12 1 56.7 40.0 3.3 14 15 1 46.7 50.0 3.3
2. Family income Per Month
• <Rs. 5000
• Rs. 5001 to 10,000
• Rs. 10,001 to 15,000
• >Rs. 15,000
5 15 2 8 16.7 50.0 6.7 26.7 9 14 4 3 30.0 46.7 13.3 10.0
3. Religion
• Hindu • Christian • Muslim • Others 26 0 4 0 86.7 0 13.3 0 27 2 1 0 90.0 6.7 3.3 0
4. Diet Pattern
• Vegetarian • Non-Vegetarian 1 29 3.3 96.7 1 29 3.3 96.7
5. Educational Status
• Non –Literate
• Primary School
• Higher secondary School
• Graduate 0 5 8 17 0 26.7 16.7 56.7 0 6 10 14 0 20.0 33.3 46.7
6. Occupation
• Unemployed
• Daily Labour
• Self employed
• Employed 28 0 0 2 93.3 0 0 6.7 29 0 1 0 96.7 0 3.3 0
7. Gravida
• Primi Gravida
• Multi Gravida
7 23 23.3 76.7 11 19 36.7 63.3
8. Para
• Primi Para
• Multi para
Ethical consideration: Ethical considerations are vital to any research study because of the influence on the researcher’s ability to acquire and retain participants. The sample selected for the present study was 60 post-natal women underwent LSCS was admitted in the post-natal ward of Mahatma Gandhi Medical College Research Institute and Hospital, Puducherry. The proposed study was conducted after the approval of the Institutional Human Ethical Committee. Permission were obtained from the concerned authorities. Informed consent were obtained from the mothers. Subjects had given the right to withdraw from the study at any time they want and assurance was given to the study subjects and parents that, the privacy and anonymity of the individual will be maintained confidentially.
Data collection procedure: The permission was obtained
from institutional ethical committee and concerned authority to conduct the study. The study was carried out from 17/10/17 to 21/11/17. Post-natal mothers undergone LSCS and who fulfilled the inclusion criteria were selected by using simple random sampling technique – lottery method. 4 to 5 women were selected per day. The investigator introduced herself to the subjects and explained about the procedure. The post-natal mothers were given opportunity to clarify their doubts regarding the intervention. After obtaining the signature in the consent form, data was collected to assess the demographic variables and a pre-test was carried out to assess the effectiveness of breast feeding by using UNICEF based breast feeding assessment tool in both the groups. Almond oil massage was applied to experimental group and routine breast care was given to the control group.
Procedure of almond oil massage: After cleaning the breast 2
ml of almond oil applied over each breast by finger pads for a period of 5 minutes two times a day (morning and evening) by stroking, rubbing, kneading and manipulating the breast to stimulate milk production and the procedure was repeated for 5 days. On 5th day post-test was conducted. Routine breast care was given for control group.
Plan for data analysis: The Researcher used Descriptive
medium and standard deviation to assess the demographic variables of postnatal mothers underwent LSCS. Inferential statistics such as Cochrane’s test and Wilcoxon Signed Rank test and Mann-Whitney test was used to compare the effectiveness of pre and post-test assessment. Chi-square test and Mann-Whitney and Kruskal Wallis test was done to find out the association between the breast milk secretions of breast feeding with selected demographic variables.
The First objective was to assess the breast milk secretion
during pre-test among postnatal mothers: The present study
findings revealed the frequency distribution of breast milk secretion in pre-test among 30 mothers of experimental group 93.3% (28) mothers had fair milk secretion (UNICEF score 27-39) 6.7% (2) mothers had Good milk secretion (UNICEF score 40-52),in control group 90.0% (27) mothers had fair milk secretion (UNICEF score 27-39), and 10.0% (3) mothers had good milk secretion (UNICEF score 40–52).
The second objective was to evaluate the effectiveness of almond oil massage on breast feeding during post-test
among postnatal mothers: The present study revealed that in
post-test among experimental group 30 mothers (100%) had very good milk secretion (UNICEF score 53–65) and in control group 30 mothers (100%) had good milk secretion (UNICEF score 40–52).
The third objective was to find out the association between the volume of breast feeding and the selected demographic
variables of postnatal mothers: The present study findings
revealed that there is no significant association between the volume of breast feeding and the selected demographic variables like age, family income per month, religion, diet pattern, educational status, occupation, gravida, and para.
DISCUSSION
• Among 60 post-natal mothers majority (31) mothers
between the age group of 18–27 years.
• The frequency distribution of breast milk secretion in pre-test among 30 mothers of experimental group Percentage distribution shows amount of breast milk secretion among post-natal mothers underwent LSCS in pre-test (N = 60)
Breast milk secretion UNICEF score Group
Total Experimental Group Control group
n % n % n %
Pre-test 27-39:Fair 28 93.3 27 90.0 55 91.7
40-52:Good 2 6.7 3 10.0 5 8.3
Percentage distribution of breast milk secretion among postnatal mothers underwent LSCS during pre-test
Breast milk
secretion UNICEF score
Group
Total Experimental Group Control group
n % n % n %
post-test 40-52:Good 0 0 30 100 30 50
53-65:Very Good 30 100 0 0 30 50
Effectiveness of almond oil massage on breast feeding among postnatal mothers underwent LSCS during pre-test and post-test
Test Experimental (n = 30) Control (n = 30) ‘t’ test value ‘p’ value Mean Standard Deviation (SD) Mean Standard Deviation (SD)
Pre-test 35.13 3.037 34.43 4.446 0.712 0.480
Post-test 63.00 1.287 43.33 2.023 44.933 <0.0001*
‘t’ test value 47.657 10.244
score 27–39) 6.7% (2) mothers had Good milk secretion (UNICEF score 40–52), in control group 90.0% (27) mothers had fair milk secretion (UNICEF score 27–39), and 10.0% (3) mothers had good milk secretion (UNICEF score 40–52) (Table 2, Figure 11).
• The frequency distribution of breast milk secretion
among postnatal mothers underwent LSCS in post-test. In post-test among experimental group 30 mothers (100%) had very good milk secretion (UNICEF score 53–65) and in control group 30 mothers (100%) had good milk secretion (UNICEF score 40–52) (Table 3, Figure 12).
• The effectiveness of breast feeding among postnatal
mothers underwent LSCS between experimental and control group in pre-test and post-test. In pre-test, the mean and SD value of experimental and control groups were 35.13, 34.43 and 3.037, 4.446, respectively.
In post-test the mean and SD values of experimental and control groups were 63.00, 43.33, and 1.287, 2.023, respectively. The obtained ‘t’test value for experimental group 47.657. ‘p’ value <0.0001*. The obtained ‘t’test value for control group 10.244 and ‘p’ value <0.0001*. While comparing experimental and control groups pre-test and post-test, In pre-test obtained ‘t’ test value 0.712 and ‘p’ value 0.480 and post-test ‘t’ value 44.933 and ‘p’ value <0.0001*.
It was inferred that almond oil massage was effective in
promoting breast feeding among post-natal mothers underwent LSCS and which can be effectively utilized as a non-pharmacological management for promotion of breast milk secretion. Hence the stated hypothesis H1
was accepted.
Regarding the association between the volume of breast
feeding and the selected demographic variables. There is no significant association between the volume of breast feeding and the selected demographic variables like age, family income per month, religion, diet pattern, educational status, occupation, gravida, and para.
Recommendation
• The study can be replicated with a larger sample for better generalization.
• More studies can be conducted on effectiveness of
almond oil massage in promoting breast feeding for mothers who undergone LSCS for alternative modalities to establish for promotion of breast feeding in maternity care.
• Nurse researcher can do studies related to other type of
alternative therapies in promoting breast milk secretion.
• A study can be conducted by including more number of
variables and at different geographic locations.
• The study can be conducted to compare the amount of
breast milk secretion among postnatal mothers in experimental group and control group in MGMC and RI at Puducherry.
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